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Buccal Fat Advancement-Transposition Flap for Reconstruction of Midface Volume Defects
Seth J Davis1, Christopher Park2, Isaac T Shipchandler2
1Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, 94301.
Facial Plastic Surgery & Aesthetic Medicine
|April 10, 2024
Summary
The pedicled buccal fat advancement-transposition (BFAT) flap offers significant volume and reach for midface reconstruction. This versatile flap can be accessed through various incisions, aiding in the repair of complex head and neck defects.
Area of Science:
- Plastic Surgery
- Head and Neck Reconstruction
- Anatomy
Background:
- The buccal fat pad (BFP) is a known reconstructive option for head and neck defects.
- Previous studies have explored its use, but detailed characterization for midface reconstruction is limited.
Purpose of the Study:
- To evaluate the utility of the pedicled buccal fat advancement-transposition (BFAT) flap for midface reconstruction.
- To determine the volume and axial reach of the BFAT flap in human anatomic specimens.
- To explore various surgical approaches for accessing the BFAT flap.
Main Methods:
- Dissection of ten adult human head and neck specimens.
- Characterization of BFAT flap volume and axial reach.
- Description of a clinical case utilizing the BFAT flap for midface defect reconstruction.
Main Results:
- The BFAT flap can be accessed via nasolabial, subciliary, and deep plane facelift incisions.
- Mean mobilizable fat volume was 7.1 cm³.
- Mean axial reach was 6.9 cm without tension.
- Successful reconstruction of a large midface defect using the BFAT flap was demonstrated.
Conclusions:
- The BFAT flap provides substantial volume and reach for midface reconstruction.
- It is harvestable through multiple dissection windows or pre-existing defects.
- The BFAT flap is a versatile option for reconstructing diverse midface defects.
